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Planning With Late-Stage Ovarian Cancer

Medically Reviewed by Carol DerSarkissian, MD on August 03, 2022

After you’ve been diagnosed with advanced ovarian cancer, planning ahead might be the last thing you want to think about. But it’s important to take time to decide what you want treatment to look like, tend to your emotional and spiritual needs, and take care of practical and legal matters.

Planning ahead not only makes things easier for your loved ones, it may help ease your mind about the challenges to come. Perhaps most importantly, it can give you a sense of control at a time when you’re facing so many unknowns.

How to Set Your Priorities

First of all, know that you’re far from alone. More than 80% of people with ovarian cancer aren’t diagnosed until the disease is in its advanced stages.

Each person will handle their diagnosis differently. You may want to keep living your daily life as usual for as long as possible. Or you might reevaluate the way you spend your time. You could choose to:

  • Devote more time to friends and family
  • Explore meaning and spirituality -- on your own or with the help of a counselor or spiritual advisor
  • Enjoy time in nature
  • Write down reflections and memories -- to share with loved ones or just to help you sort out your thoughts
  • Visit a special destination
  • Learn about something you’ve always been curious about

Only you can decide what’s most important to you. Ovarian cancer and its treatments take a toll on your time and physical well-being. Once you’ve thought about what matters most, you can make better decisions about how to use your energy when you have it.

Planning for Your Health Care

You also have decisions to make about how much and what type of treatment you want.

Start with some honest conversations with your cancer doctor. They can’t predict your personal outcome. But they can tell you how far your cancer has spread, what your treatment options are, and what you might expect. Even if your doctors can’t cure your advanced ovarian cancer, they may be able to control it and ease symptoms for months or years.

In turn, be open with your health care team about your goals. You may want to treat the cancer aggressively, and deal with any side effects that come up. Or your top priority may be quality of life, which could mean stopping treatment altogether.

It’s not an easy topic to think about. But consider what quality of life means to you:

  • Is maximizing your lifespan your main goal?
  • How much discomfort are you willing to put up with?
  • Is it important for you to keep living at home?
  • How do your health care decisions mesh with your spiritual or religious beliefs?

Talk to your caregivers and loved ones about your wishes. To spare them the anxiety of uncertainty, it’s best to capture your health care decisions in legal documents known as advance directives. They include:

Living will. This document spells out the treatments and support you would – and wouldn’t want – if you became very ill. This includes life support devices like feeding tubes and mechanical respirators as well as emergency measures like cardiopulmonary resuscitation (CPR). A living will may also contain instructions about organ donation.

Health care power of attorney (also called health care proxy). In this document, you name an adult who can make health care decisions for you if you become unable to make them yourself.

Do-not-resuscitate (DNR) order. If your heart or breathing stops, medical providers must try to restart them unless you have a DNR order. This document details what kind of care you’d want in this case. You can include it in your living will, or have one by itself.

The forms and requirements for these documents vary from state to state. You may need to get your directives notarized or have a witness sign them. You don’t necessarily need a lawyer to complete them. Your hospital or a social worker may be able to direct you to a website that contains the forms for your state.

Make sure your health care providers and caregivers have a copy of your documents. You can update your directives if you change your mind about something.

Financial and Practical Planning

Getting your financial and legal affairs in order makes things less complicated for your loved ones. It may also help you focus on your cancer treatment and your other life priorities.

Check with your insurance provider early on about what cancer treatments are covered. Find out how much coverage you have for things like home health care and hospice. If you’re concerned about paying medical bills, talk with a social worker or financial advisor. They can help you organize your finances and come up with a plan to deal with debt.

To make sure your financial wishes are carried out, consider these legal documents:

Financial power of attorney. Similar to a health care power of attorney, this authorizes someone to make financial decisions for you if you become unable to.

Will. It specifies how your property and finances should be handled after you die. A will can save your loved ones from complicated and expensive legal battles. If you’re a single parent, your will can specify who your children’s guardian will be.

Each state has its own laws about wills and financial powers of attorney. While you can create your own using online templates, an attorney can make sure your documents meet legal requirements. Organizations in your state may provide free or low-cost legal services for people with cancer.

Share these documents with your loved ones. Keep them with your attorney or in a safe place, along with other essential papers like your:

  • House deed and mortgage information
  • Car titles
  • Birth and marriage certificates
  • Social security card
  • Policy documents for health, homeowners, rental, and life insurance
  • Bank, credit card, and investment account statements
  • Tax documents
  • Pension and retirement account information

Create a list of your online accounts and share the passwords with your loved ones. Make sure they know how to contact your attorney and accountant, if needed.

Leaving a Legacy

If your cancer continues to advance, you can ease some of the burden on your loved ones by letting them know of your wishes for a funeral or memorial service. You might want a formal religious service, or one that’s more of a celebration of life. You may wish to be buried or inurned in a certain location, or to have your ashes scattered someplace that’s special to you. Talk to your friends and family or leave them written instructions.

Think about taking some time to reflect on and celebrate your life and accomplishments. You may want to share these reflections with people you love. You might:

  • Give away keepsakes and mementos to your loved ones
  • Make a scrapbook, online photo album, video, or recording to celebrate special memories
  • Write letters to your friends and family members
  • Create a family tree
  • Gather special recipes into a cookbook

Whatever you choose, it should bring joy and meaning to the time you have left.

Show Sources

SOURCES:

Cancer Research UK: “Coping if your ovarian cancer can't be cured.”

National Cancer Institute: “Planning for Advanced Cancer.”

American Cancer Society: “Cancer Facts & Figures 2018 - Special Section: Ovarian Cancer.”

American Society of Clinical Oncology: “Advanced Cancer Care Planning.”

Mayo Clinic: “Living wills and advance directives for medical decisions.”

American Bar Association: “Cancer Advocacy Pro Bono Legal Referral Services.”

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